Gender, Feeding, and Eating Disorders

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The male in this case is a young, homosexual business man. He reported that his consulting business has been successful. He stated that he is unhappy however, because he has been unable to maintain a romantic relationship. He attributes this to his belief that he is unattractive, specifically that he feels he has “love handles.” He reported that he is in good health. He is 5’11 and 155 pounds. He reported he has healthy eating habits, although he does not eat dinner. He does not drink, and exercises regularly. It troubles him that he is unable to lose the excess fat around his abdominal area. He has been told by others, including his doctor that he is too thin however, he as disregarded such comments and maintains he is flabby in his abdominal area (Laureate Education, 2012).

According to the BMI calculator form the Centers for Disease Control and Prevention (2018), the man is within the normal weight range. However, if others have commented that he appears too thin, he may not have reported his weight accurately to the therapist. According to the DSM-5, an individual’s body mass index must be under 17 to have mild anorexia nervosa. If this man’s weight was approximately 125 pounds, the diagnosis for the male would be anorexia nervosa. Given his current, restrictive diet however, he appears to be on the path to anorexia nervosa, restricting type. He appears to be restricting his energy intake relative to his body’s requirements. He meets other criteria for the disorder in that he clearly fears gaining weight. His food intake is very restrictive, and he exercises excessively to prevent weight gain. Increases in physical activity frequently precedes the onset of anorexia nervosa. The male has a disturbance in his perceived weight and shape. Despite the comments of others that he is too thin or that he looks in shape, the male maintains he is overweight. He has an abnormal body image. He believes his former boyfriend ended their relationship and that he cannot maintain relationships because of his belief that he is overweight. The male has depressive symptoms and the disorder has disrupted his social life (APA, 2013; Paris, 2015).

According to McFarland & Petrie (2012), males are pressured to be muscular which can lead to feelings of dissatisfaction with body appearance. This can result in restrictive dieting, excessive exercise, weight lifting and use or abuse of supplements. In their pursuit of social desirability and muscularity, a male’s level of satisfaction with his body is related to eating disorders, his psychological health, and negative affect and mood.

Anorexia nervosa is most common in high-income, highly industrialized countries and is most prevalent among young females (APA, 2013; Paris, 2015). However, according to American Addiction Centers (2018), 25% of individuals diagnosed with anorexia are male, and 42% of males with anorexia are gay. Due to the prevalence of eating disorders in the gay community, there is an awareness that can lead to treatment. There are several aspects of the gay male culture that increases the risk of anorexia nervosa which should be considered during the diagnostic process. The traditional gay male body is leaner than males who are straight. Therefore, gay men often feel they must be thin to attract other gay men. This may lead these men to unhealthy eating habits to achieve a lean body. A restrictive diet triggering anorexia can affect a man’s hormones which can cause him to feel less sexual, overall. For men who are not prepared to identify as gay but have sexual feelings for men, they can control their sexual feelings from erupting by restricting their diets. Also, at risk for anorexia nervosa are men who experienced severe abuse as children, including sexual abuse, sexual harassment, and bullying. Anorexia can develop from feelings of lifelong victimization and feeling loss of control from such experiences. Anorexia allows these men to control how they are perceived by others. By altering body shape and size, a man can feel as though he is not vulnerable as he was when he was larger (American Addiction Centers, 201

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